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Subarachnoid hemorrhage randomized

Qiang Tan, Qianwei Chen, Zhou Feng, Xia Shi, Jun Tang, Yihao Tao, Bing Jiang, Liang Tan, Hua Feng, Gang Zhu, Yunfeng Yang, Zhi Chen
Fibrosis in ventricular system has a role in hydrocephalus following intraventricular hemorrhage (IVH). The cannabinoid receptor 2 (CB2) has been reported to participate in alleviating the fibrosis process of many diseases. However, its role in fibrosis after IVH was unclear so far, and we hypothesized that CB2 activation has potential to attenuate hydrocephalus after IVH via restricting fibrosis. So the present study was designed to investigate this hypothesis in a modified rat IVH model. Autologous non-anticoagulative blood injection model was induced to mimic ventricular extension of hemorrhage in adult Sprague-Dawley rats...
October 18, 2016: Brain Research
Zhao Chenhui, Wei Yi
BACKGROUND: Despite great advances in treatment of Aneurysmal subarachnoid hemorrhage (aSAH), yet, a consensus as to the most optimal timing of surgery has not been reached. MATERIALS AND METHODS: PubMed and the Cochrane Library were searched for English-language studies published up to May 2015. Before conducting the meta-analysis, the studies were evaluated for publication bias and heterogeneity. Fixed and random effect models were used to estimate relative risks (RR) and the corresponding 95% confidence intervals (CIs)...
December 7, 2015: Turkish Neurosurgery
Davide Croci, Edin Nevzati, Hiroki Danura, Salome Schöpf, Javier Fandino, Serge Marbacher, Carl Muroi
BACKGROUND: In subarachnoid hemorrhage (SAH), occurrence of cerebral vasospasm (CVS) mediated by endothelin (ET)-1 might be a result of a compartmental inflammatory response with interleukin (IL)-6 release. We aim to investigate the relationship between ET-1 and IL-6 in association of CVS. METHODS: A total of 24 New Zealand white rabbits where randomly allocated into 3 groups: SAH (n=10), IL-6 (n=10), and sham (n=4). SAH was induced by a closed cranium extracranial-intracranial shunt model...
October 19, 2016: Journal of Neurosurgical Sciences
Cong Qian, Xiaobo Yu, Jingyin Chen, Chi Gu, Lin Wang, Gao Chen, Yuying Dai
BACKGROUND AND OBJECTIVES: Vasospasm-related injury such as delayed ischemic neurological defect (DIND) or cerebral infarction is an important prognostic factor for aneurismal subarachnoid hemorrhage (SAH). Whether cerebrospinal fluid (CSF) drainage can achieve a better outcome in aneurismal SAH patients after coiling or clipping remains the subject of debate. Here, we report a meta-analysis of the related available literature to assess the effect of continuous CSF drainage on clinical outcomes in patients with aneurismal SAH...
October 2016: Medicine (Baltimore)
Fumihiro Kawakita, Masashi Fujimoto, Lei Liu, Fumi Nakano, Yoshinari Nakatsuka, Hidenori Suzuki
Toll-like receptor 4 (TLR4) signaling may play a crucial role in the occurrence of cerebral vasospasm after subarachnoid hemorrhage (SAH). The main purpose of this study was to assess if selective blockage of TLR4 on cerebral arteries prevents cerebral vasospasm development and neurological impairments after SAH in mice. One hundred fourteen mice underwent endovascular perforation SAH or sham operation and were randomly divided into the following 6 groups: sham+vehicle, sham+LPS-RS ultrapure 8 μg, sham+LPS-RS ultrapure 40 μg, SAH+vehicle, SAH+LPS-RS ultrapure 8 μg, and SAH+LPS-RS ultrapure 40 μg...
October 13, 2016: Molecular Neurobiology
Xiang-Sheng Zhang, Qi Wu, Ling-Yun Wu, Zhen-Nan Ye, Tian-Wei Jiang, Wei Li, Zong Zhuang, Meng-Liang Zhou, Xin Zhang, Chun-Hua Hang
Increasing evidence indicates that sirtuin 1 (SIRT1) is implicated in a wide range of cellular functions, such as oxidative stress, inflammation and apoptosis. The aim of this study was to investigate the change of SIRT1 in the brain after subarachnoid hemorrhage (SAH) and its role on SAH-induced early brain injury (EBI). In the first set of experiments, rats were randomly divided into sham group and SAH groups at 2, 6, 12, 24, 48 and 72 h. The expression of SIRT1 was evaluated by western blot analysis, immunohistochemistry and immunofluorescence...
October 13, 2016: Cell Death & Disease
Zhen-Nan Ye, Zong Zhuang, Ling-Yun Wu, Jing-Peng Liu, Qiang Chen, Xiang-Sheng Zhang, Meng-Liang Zhou, Zi-Huan Zhang, Wei Li, Xiao-Liang Wang, Chun-Hua Hang
Convincing evidence supports that nuclear factor kappa B (NF-κB)-meditated inflammation contributes to the adverse prognosis of aneurysmal subarachnoid hemorrhage (SAH), and pathologic neutrophil accumulation after SAH in the brain parenchyma enhances the inflammatory process. Leukotriene B4 (LTB4) is a highly potent lipid chemoattractant of neutrophils, and its biological effects are mediated primarily through the high-affinity LTB4 receptor 1 (BLT1). It is verified that NF-κB-dependent BLT1 mediates LTB4 signaling and LTB4 stimulates NF-κB-dependent inflammation via BLT1...
October 7, 2016: Brain Research
Jian Shen, Kai-Yuan Huang, Yu Zhu, Jian-Wei Pan, Hao Jiang, Yu-Xiang Weng, Ren-Ya Zhan
OBJECTIVE The efficacy of statin therapy in treating aneurysmal subarachnoid hemorrhage (SAH) remains controversial. In this meta-analysis, the authors investigated whether statin treatment significantly reduced the incidence of cerebral vasospasm and delayed neurological deficits, promoting a better outcome after aneurysmal SAH. METHODS A literature search of the PubMed, Ovid, and Cochrane Library databases was performed for randomized controlled trials (RCTs) and prospective cohort studies investigating the effect of statin treatment...
October 7, 2016: Journal of Neurosurgery
Ye Xiong, Xue-Min Wang, Ming Zhong, Ze-Qun Li, Zhi Wang, Zuo-Fu Tian, Kuang Zheng, Xian-Xi Tan
The aim of the present study was to evaluate the expression levels of caveolin-1 in the basilar artery following delayed cerebral vasospasm (DCVS) in a rat model of subarachnoid hemorrhage (SAH), in order to investigate the association between caveolin-1 and DCVS, and its potential as a treatment for DCVS of SAH. A total of 150 Sprague Dawley rats were randomly allocated into blank, saline and SAH groups. The SAH and saline groups were subdivided into days 3, 5, 7 and 14 following the establishment of the model...
October 2016: Experimental and Therapeutic Medicine
Xiyang Yao, Kai Zhang, Jieyong Bian, Gang Chen
The association between alcohol consumption and the risk of subarachnoid hemorrhage (SAH) is inconsistent. Thus, meta- and a dose-response analyses are presented with the purpose of assessing their associations. A systematic literature search was performed using Pubmed and Embase electronic databases for pertinent observational studies. Random-effects or fixed-effect models were employed to combine the estimates of the relative risks (RRs) with corresponding 95% confidence intervals (CIs). A dose-response pattern was conducted for further analysis...
October 2016: Biomedical Reports
Sannepaneni Kranthi, Barada P Sahu, Purohit Aniruddh
CONTEXT: Poor grade subarachnoid hemorrhage (SAH) is usually associated with unfavorable outcomes and optimal management is deemed complicated. Most centres follow an expectant management strategy or a less aggressive approach till patients improve to good clinical grades. This approach has been associated with higher mortality and morbidity. However, not all patients with poor clinical condition fare badly. Identification and early aggressive management of this select group of patients may lead to favorable outcomes...
October 2016: Asian Journal of Neurosurgery
Nefize Turan, Brandon A Miller, Robert A Heider, Maheen Nadeem, Iqbal Sayeed, Donald G Stein, Gustavo Pradilla
The most important aspect of a preclinical study seeking to develop a novel therapy for neurological diseases is whether the therapy produces any clinically relevant functional recovery. For this purpose, neurobehavioral tests are commonly used to evaluate the neuroprotective efficacy of treatments in a wide array of cerebrovascular diseases and neurotrauma. Their use, however, has been limited in experimental subarachnoid hemorrhage studies. After several randomized, double-blinded, controlled clinical trials repeatedly failed to produce a benefit in functional outcome despite some improvement in angiographic vasospasm, more rigorous methods of neurobehavioral testing became critical to provide a more comprehensive evaluation of the functional efficacy of proposed treatments...
September 27, 2016: Journal of Cerebral Blood Flow and Metabolism
Yan Wen, Chao Zhang, Xiao-Feng Zhao, Shi-Zhe Deng, Si He, Ling-Hui Huang, Guang Tian, Zhi-Hong Meng
Acupuncture at Fengchi (GB20) in the posterior neck improves vertigo. However, subarachnoid hemorrhage and spinal epidural hematoma have been reported to occur after acupuncture in the posterior neck. Therefore, in the present study, we assessed the safety of acupuncture at Fengchi. Laboratory tests and adverse event reports were used to evaluate the safety of different acupuncture manipulations for the treatment of posterior circulation ischemia with vertigo. A total of 136 patients were randomly assigned to four groups...
August 2016: Neural Regeneration Research
Hadie Adams, Vin Shen Ban, Ville Leinonen, Salah G Aoun, Jukka Huttunen, Taavi Saavalainen, Antti Lindgren, Juhana Frosen, Mikael Fraunberg, Timo Koivisto, Juha Hernesniemi, Babu G Welch, Juha E Jaaskelainen, Terhi J Huttunen
BACKGROUND AND PURPOSE: Shunt dependent hydrocephalus after aneurysmal subarachnoid hemorrhage (aSAH) is a common sequela that may lead to poor neurological outcome and predisposes to various interventions, admissions, and complications. We reviewed post-aSAH shunt dependency in a population-based sample and tested the feasibility of a clinical risk score to identify subgroups of aSAH patients with increasing risk of shunting for hydrocephalus. METHODS: A total of 1533 aSAH patients from the population-based Eastern Finland Saccular Intracranial Aneurysm Database (Kuopio, Finland) were used in a recursive partitioning analysis to identify risk factors for shunting after aSAH...
October 2016: Stroke; a Journal of Cerebral Circulation
Shane W English, Lauralyn McIntyre, Dean Fergusson, Alexis Turgeon, Marlise P Dos Santos, Cheemun Lum, Michaël Chassé, John Sinclair, Alan Forster, Carl van Walraven
OBJECTIVE: To create an accurate prediction model using variables collected in widely available health administrative data records to identify hospitalizations for primary subarachnoid hemorrhage (SAH). METHODS: A previously established complete cohort of consecutive primary SAH patients was combined with a random sample of control hospitalizations. Chi-square recursive partitioning was used to derive and internally validate a model to predict the probability that a patient had primary SAH (due to aneurysm or arteriovenous malformation) using health administrative data...
October 11, 2016: Neurology
A Rocca, J-M Pignat, L Berney, J Jöhr, D Van de Ville, R T Daniel, M Levivier, L Hirt, A R Luft, E Grouzmann, K Diserens
BACKGROUND: Patients who experience severe brain injuries are at risk of secondary brain damage, because of delayed vasospasm and edema. Traditionally, many of these patients are kept on prolonged bed rest in order to maintain adequate cerebral blood flow, especially in the case of subarachnoid hemorrhage. On the other hand, prolonged bed rest carries important morbidity. There may be a clinical benefit in early mobilization and our hypothesis is that early gradual mobilization is safe in these patients...
September 13, 2016: BMC Neurology
Brian Sindelar, Julian E Bailes, Sydney Ann Sherman, John Desmond Finan, James Stone, John M Lee, Saman Ahmadian, Ying Zhou, Vimal Patel, David Smith
Internal jugular vein (IJV) compression has been shown to reduce axonal injury in pre-clinical traumatic brain injury models and clinical concussion studies. However, this novel approach to prophylactically mitigating traumatic brain injury (TBI) through venous congestion raises concerns of increasing the propensity for hemorrhage and hemorrhagic propagation. This study aims to test the safety of IJV compression in a large animal controlled cortical impact (CCI) injury model and the resultant effects on hemorrhage...
August 29, 2016: Journal of Neurotrauma
Jimmy Ghostine, Naim Khoury, Francis Cloutier, Marc Kotowski, Jean-Christophe Gentric, André L Batista, Alain Weill, Daniel Roy, Tim E Darsaut, Jean Raymond
BACKGROUND: Endovascular coil embolization of cerebral aneurysms is an effective treatment for the prevention of aneurysm rebleeding after subarachnoid hemorrhage. It is also often used in unruptured aneurysms, but it is associated with aneurysm remnants and recurrences in up to 20%-33% of patients. We hypothesized that better aneurysm occlusion rates can be achieved with coils of larger caliber. METHODS: The Does Embolization with Larger coils lead to better Treatment of Aneurysms (DELTA) trial is an investigator-initiated, multicenter, prospective, randomized, controlled clinical trial...
August 16, 2016: Interventional Neuroradiology
Yahya Guvenc, Adnan Demirci, Deniz Billur, Sevim Aydin, Ersin Ozeren, Pinar Bayram, Alper Dilli, Emre Cemal Gokce, Onur Yaman, Haydar Celik, Mete Karatay, Fatih Alagoz, Erkan Kaptanoglu
Background This study investigated the effect of Punica granatum L. (pomegranate) juice on the rabbit basilar artery in an experimental subarachnoid hemorrhage (SAH) model. Methods Eighteen adult male New Zealand white rabbits were randomly divided into three groups: a control group (n = 6), SAH group (n = 6), and SAH + treatment group (n = 6). Basilar artery diameter was measured with magnetic resonance angiography (MRA) in all groups at the beginning of the study. Experimental SAH was created by injecting autologous arterial blood into the cisterna magna...
August 10, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Jacob K Greenberg, Ridhima Guniganti, Eric J Arias, Kshitij Desai, Chad W Washington, Yan Yan, Hua Weng, Chengjie Xiong, Emily Fondahn, DeWitte T Cross, Christopher J Moran, Keith M Rich, Michael R Chicoine, Rajat Dhar, Ralph G Dacey, Colin P Derdeyn, Gregory J Zipfel
OBJECTIVE Despite persisting questions regarding its appropriateness, 30-day readmission is an increasingly common quality metric used to influence hospital compensation in the United States. However, there is currently insufficient evidence to identify which patients are at highest risk for readmission after aneurysmal subarachnoid hemorrhage (SAH). The objective of this study was to identify predictors of 30-day readmission after SAH, to focus preventative efforts, and to provide guidance to funding agencies seeking to risk-adjust comparisons among hospitals...
August 5, 2016: Journal of Neurosurgery
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